Antiretroviral Therapy for Patients with HIV-HBV Coinfection

It was shown that people who have Hepatitis B virus-HIV (HBV-HIV) coinfection have a greater chances of developing advanced liver disease than those who only have monoinfections. Also, it was shown that HIV patients who have acuted HBV infection have lesser chances of recovery, that is, removing the virus from the system.

In an excerpt from HIVandHepatitis.com , it reads:

HIV-infected adults with acute HBV infection are less likely to eliminate the virus compared with HIV negative adults (23% vs 4%). Without hepatitis B treatment, HIV-HBV coinfected patients have higher HBV DNA levels and a longer duration of viremia, but may have lower transaminase (liver enzyme) levels compared with HBV monoinfected patients. HIV-HBV coinfected individuals also have a higher rate of liver-related morbidity than persons with either virus alone.

What makes transaminase important in the determination of liver infection along with its health is discussed briefly in the article in Wikipedia below:

The biochemical hub of the body, the liver, has a variety of transaminases to synthesize and break down amino acids and to interconvert energy storage molecules. The concentrations of these in the serum (the non-cellular portion of blood) are normally low. However, if the liver is damaged, the hepatocyte cell membrane becomes more permeable and some of the enzymes leak out into the blood stream.

While it is very important that both infection should be treated accordingly, the type of treatment should be based on individual need and current health situation. Symptoms that are currently manifesting should be treated first before looking into other possible factors that as, I quote,

* the need for combination antiretroviral therapy for HIV
* severity of liver disease
* likelihood of treatment response, and
* potential adverse events

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